The past few days have seen the simultaneous publication of the first
vetted medical-journal pieces on the vast European outbreak of E. coli O104. They’re fascinating for what they report that is new about this
perplexing epidemic — now up to 3,802 cases including 43 deaths, according to the World Health Organization — and also for the further questions they raise.

Possibly most headline-worthy: Two reports in Eurosurveillance,
Europe’s peer-reviewed open-access epidemiology journal, that suggest
this strain is communicable from person to person and also produces
unusual and troubling symptoms.

The person-to-person case first: A team from Leiden University Medical Centre in the Netherlands describe the experience of seven members of a Dutch family who were visiting Germany in the first weeks of the epidemic and then
returned home about May 15. The young mother in the family came to the
hospital May 24 after having abdominal pain and bloody diarrhea for two
days. They thought she had common gastroenteritis — a bacterial or viral
infection of the gut, which usually resolves on its own in a few days —
and so did not give her antibiotics. Nevertheless, four days later, she
developed severe hemolytic uremic syndrome (HUS), the dangerous
after-effect of infection with E. coli strains that produce
toxins, which destroy red blood cells, clogging the kidneys and bringing
on kidney failure. HUS is often brought on by misapplied antibiotic
treatment in toxin-producing (STEC) E. coli cases, but, in this case, the woman had not received any.